HER-2、CA153及HE4联合检测对乳腺癌的诊断价值

目的探讨联合检测血清人表皮生长因子2(HER-2)、癌抗原153(CA153)及人附睾蛋白4(HE4)对乳腺癌的诊断价值。方法选取该院收治的乳腺癌患者60例(乳腺癌组),乳腺良性疾病患者80例(乳腺良性疾病组)及同期的体检健康妇女60例(对照组)为研究对象。比较3组患者血清HER-2、CA153及HE4水平,并分析3项指标单独及联合检测对乳腺癌的诊断价值。结果乳腺癌组患者血清HER-2、CA153及HE4水平(27.64±7.49)mg/mL、(48.25±11.36)U/mL、(183.46±27.39)pmol/L]显著高于乳腺良性疾病组和对照组(13.57±3.51)mg/mL、(20.14±6.24)U/mL、(81.35±21.46)pmol/L;(10.26±2.37)mg/mL、(14.37±3.92)U/mL、(43.77±14.51)pmol/L],差异有统计学意义(P<0.05)。乳腺癌组HER-2、CA153及HE4表达阳性率(30.0%、48.3%、36.7%)显著高于乳腺良性疾病组和对照组(5.0%、13.8%、8.8%;0.0%、3.3%、1.7%),差异有统计学意义(P<0.05),且乳腺癌患者CA153表达阳性率(48.3%)显著高于HER-2和HE4(30.0%、36.7%),差异有统计学意义(P<0.05)。乳腺癌患者Ⅳ期血清HER-2、CA153及HE4水平(40.27±12.45)mg/mL、(78.25±17.36)U/mL、(193.82±32.66)pmol/L]显著高于Ⅰ~Ⅱ期和Ⅲ期(12.48±3.14)mg/mL、(25.73±7.48)U/mL、(142.16±21.37)pmol/L;(22.63±6.38)mg/mL、(43.61±13.62)U/mL、(153.49±25.61)pmol/L],Ⅲ期血清HER-2、CA153及HE4水平(22.63±6.38)mg/mL、(43.61±13.62)U/mL、(153.49±25.61)pmol/L]显著高于Ⅰ~Ⅱ期(12.48±3.14)mg/mL、(25.73±7.48)U/mL、(142.16±21.37)pmol/L],差异有统计学意义(P<0.05)。血清HER-2、CA153及HE4联合检测的灵敏度(71.9%)及准确度(80.0%)均显著提高(P<0.05)。结论血清HER-2、CA153及HE4联合检测可提高对乳腺癌的检出率,且还可作为病情严重程度和治疗监测的辅助检查指标。

The diagnostic value of combined detection of HER-2,CA153 and HE4 in breast cancer

Objective To explore the diagnostic value of combined detection of human epidermal growth factor-2(HER-2),cancer antigen 153(CA153)and human epididymal protein 4(HE4)in breast cancer.Methods The 60 cases of breast cancer patients(breast cancer group),80 cases of benign breast diseases(benign breast disease group)and 60 cases of healthy women(control group)in the same period were selected from our hospital.The serum levels of HER-2,CA153 and HE4 were compared between the three groups,and the diagnostic value of the three indexes alone and in combination in breast cancer was analyzed.Results The levels of serum HER-2,CA153 and HE4 in breast cancer group(27.64±7.49)mg/mL,(48.25±11.36)U/mL,(183.46±27.39)pmol/L]were significantly higher than those in benign breast disease group and control group(13.57±3.51)mg/mL,(20.14±6.24)U/mL,(81.35±21.46)pmol/L;(10.26±2.37)mg/mL,(14.37±3.92)U/mL,(43.77±14.51)pmol/L],the difference of breast cancer was statistically significant(P<0.05).The positive rate of HER-2,CA153 and HE4 expression(30.0%,48.3%,36.7%)in breast cancer group were significantly higher than that in benign breast disease group and control group(5.0%,13.8%,8.8%;0.0%,3.3%,1.7%),,the difference of breast cancer was statistically significant(P<0.05),and the positive rate of CA153 expression(48.3%)in breast cancer group was significantly higher than that of HER-2 and HE4(30.0%,36.7%),the difference of breast cancer was statistically significant(P<0.05).The levels of serum HER-2,CA153 and HE4(40.27±12.45)mg/mL,(78.25±17.36)U/mL,(193.82±32.66)pmol/L]in stageⅣin patients with breast cancer were significantly higher than those in stageⅠ-ⅡandⅢ(12.48±3.14)mg/mL,(25.73±7.48)U/mL,(142.16±21.37)pmol/L;(22.63±6.38)mg/mL,(43.61±13.62)U/mL,(153.49±25.61)pmol/L],and serum HER-2,CA153 and HE4 levels(22.63±6.38)mg/mL,(43.61±13.62)U/mL,(153.49±25.61)pmol/L]in stageⅢwere significantly higher than in stageⅠ-Ⅱ(12.48±3.14)mg/mL,(25.73±7.48)U/mL,(142.16±21.37)pmol/L],the difference of breast cancer was statistically significant(P<0.05).The sensitivity(71.9%)and accuracy(80.0%)of the combined detection of serum HER-2,CA153 and HE4 were significantly improved(P<0.05).Conclusion The combined detection of HER-2,CA153 and HE4 in serum can improve the detection rate of breast cancer,and can also be used as an auxiliary index of disease severity and treatment monitoring.